van Cleef Anne N H, Schuurman Marijn J, Busari Jamiu O
Department of Pediatrics, Atrium Medical Centre, Heerlen, The Netherlands.
BMJ Case Rep. 2011 Oct 4;2011:bcr0720114547. doi: 10.1136/bcr.07.2011.4547.
Alcohol abuse is a major problem among adolescents, and has both acute, potentially lethal, and long-term harmful effects. The authors describe an adolescent who was in a subcomatose condition after binge drinking. His serum alcohol concentration was 3.7 g/l. The next morning, before transfer to the paediatric ward, he developed a third-degree atrioventricular (AV) block without cardiac output while his infusion needle was removed. This recovered spontaneously after a precordial thump. Retrospectively, electrocardiography showed an increasing PR prolongation (200-300 ms) before the removal of the infusion needle. ECG recordings several hours later showed a first-degree AV block, which was no longer seen during follow-up, 1 month later. The authors conclude that acute alcohol poisoning has the potential to prolong the PR interval in young, healthy adolescents without pre-existing first-degree AV block and provoke a third-degree AV block after vagal stimulation. It is yet another potential danger of acute alcohol intoxication in this age group.
酒精滥用在青少年中是一个主要问题，它具有急性、潜在致命性以及长期有害影响。作者描述了一名青少年，他在暴饮后处于亚昏迷状态。其血清酒精浓度为3.7克/升。第二天早晨，在转至儿科病房之前，当拔除他的输液针时，他出现了三度房室传导阻滞且无心输出量。经胸前叩击后此情况自发恢复。回顾性分析显示，在拔除输液针之前心电图显示PR间期逐渐延长（200 - 300毫秒）。数小时后的心电图记录显示一度房室传导阻滞，1个月后的随访期间此情况不再出现。作者得出结论，急性酒精中毒有可能延长年轻健康青少年（无既往一度房室传导阻滞）的PR间期，并在迷走神经刺激后引发三度房室传导阻滞。这是该年龄组急性酒精中毒的又一潜在危险。
